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Three challenges for the health system

17 marzo, 2021 • By

I would like to take advantage of this blog to publically reflect on and provide my post-pandemic vision. You know, those of you who follow these blog entries, that I often like to reflect on and analyze the current situation, in order to try to stay ahead of the game and make the best decisions for my organization, for the great professionals that work within it and, above all, for the citizens and their healthcare. Therefore, based on my analysis of the current problems and challenges of the healthcare systems, I would like to explain why I think that we will be dealing with impact of Covid in the medium and long term.

I think that there are sectors such as tourism, hospitality and leisure that, although they have had a tough year, with closures and restricted opening times and capacity, will overcome the crisis quickly. If they have survived this year of the pandemic  without vaccines, although unfortunately many haven’t, it is highly probable that they will be able to regain their strength and value for the Spanish economy within a few months, once production and distribution of the Covid vaccines is normalized, the restrictions are relaxed or removed and citizens feel safer. In other sectors, such as that of the industrial, recovery may take longer, because consumption needs to be reactivated. But if our leaders take good advantage of the boost of European funds, we will be able to overcome the crisis and, even, allow a genuine industrial policy that strengthens industries that a year ago we didn’t believe to be as necessary.

But I have absolutely no doubt that this pandemic is going to have many repercutions on the healthcare systems all around the world, in the medium to long term. It has been shown that although Covid has limited the movement between countries, globalization is a reality and it will continue to be so after this healthcare crisis. And, therefore, the problems of many are and will become the problems of everyone, in spite of the shortsightedness of those who think Spain is the only reality that exists, ignoring the fact that we live in an open world.

And why am I saying that we are going to live with the consequences of this pandemic in the medium and long term? I’m going to explain in a very schematic way. There are three elements that are going to put pressure on the healthcare systems which will be unbearable, if we don’t remedy them.

  1. The increase in costs. And I’m referring not only  to the short term, but the need to hire more staff in order to strengthen services, cover leave, buy vaccines, protective gear for professionals, Covid tests for patients, etc. Also for the repercutions of this illness itself that are not yet known. The healthcare professionals are warning, after one year, of neurological effects, not only psychological but also physical, that affect organs and systems such as the respiratory system, and that they will continue and put pressure on healthcare, lasting beyond the short term. In fact, I don’t believe we know all of the consequences of the virus and its impact on the physical and emotional health of the population yet.
  2. The worsening of surgical waiting lists.  We are experiencing the worst waiting lists in public healthcare in not only Spain but also in other countries. All resources have been dedicated to the urgency of the pandemic and interventions have been postponed which has caused a delay, even greater than before, of waiting times for patients. That, in addition, is going to be difficult to recover from without collaboration from private healthcare. This is because I think we will keep experiencing “pandemic waves”, which won’t be of the same intensity as the current ones, but that at certain times of the year will place such pressure on healthcare that it will be necessary to temporarily delay interventions and consultations to attend to emergencies, as has happened on occasion until now with the flu. In this way, if the waiting lists were already a problem, now they will be even more so. Furthermore, we are now seeing that these waiting lists are causing more complex interventions, with a worse prognosis and a slower recovery time, with all of the impact being on wellbeing and the cost that it generates.
  3. The delay in diagnoses and treatments. Our Head of Emergencies in Ribera Povisa Hospital, Ángel Martín Joven, outlined it very well a few days ago, in an interview in La Voz de Galicia: “There is a hidden pandemic, above all among the elderly, who don’t come to Emergencies through fear of coronavirus. They downplay chest pain, for example, that we later discover was a heart attack that we would have been able to treat if they had come to the hospital”. This is the other reality of the pandemic. We found, months ago, that many patients aren’t going to check-ups, health examinations, diagnostic tests and Emergencies through fear of contracting it. In addition, the delay in diagnostic tests and specialized treatments, such as scans, radiotherapy, etc. means, as we said in point 2, treating diseases such as cancer at a later stage, having a significant impact on the prognosis, complexity and recovery as we have already mentioned.

The combination of these three elements results in unsustainable pressure on the healthcare system in the medium term. And faced with this situation, if anyone thinks that the solution or political response, “the citizen rescue program”, is to nationalize the healthcare system, they live on another planet. Or perhaps even in another galaxy. Some people even talk about a public pharmaceutical industry and nationalizing pharmacies…I will never tire of repeating that what we need to do is combine resources and seek consensus and coordination between organizations and administrations, in order to give a solution to today’s problems, which are a real threat to the healthcare of tomorrow. And I’m referring to the literal “tomorrow”, because time is against us. I hope that policy makers and healthcare managers in Spain are aware of this reality, because the image that they transmit – which I’m not saying is true, but rather that which is reflected – is that of those who put seats first, fleeting leadership and power games before the health of the citizens.

It is sad that at this point in the 21st century and after suffering with the pandemic, political leaders are not capable of speaking normally about collaboration with the private sector to face this tragedy. I can’t understand how with what we are experiencing there are those who think that, rather than publically acknowledging the work of all professionals, private healthcare is considered to be less than public, when vaccinating their professionals and acknowledging their work. A true public service is one that provides solutions to the real problems of the citizens, in order to improve their wellbeing and quality of life. Everything else is secondary. I would like to think that politicians, at least, have learned this during the tragedy that we are experiencing.